Mayo's dominance skews health insurance exchange in SE Minnesota

ROCHESTER, Minn. -- As Minnesota rolls out its health insurance exchange, residents in the southeastern part of the state are finding the costs are high and the options are few.

Experts say that's because the Mayo Clinic is a dominant presence and has the ability to set prices. Mayo's quality of care is high, but people who have to buy their own insurance and don't qualify for subsidies under the federal health care overhaul pay the price, Minnesota Public Radio reported Monday.

Rochester resident Sandra Toogood checked her options a week after the launch of the MNsure marketplace and found just one -- a Blue Cross Blue Shield plan that would cost more than she currently pays. She earns enough that she doesn't quality for a subsidy, and the unsubsidized option on MNsure for a 55-year-old Rochester resident like Toogood is $594 a month for a mid-level plan. In the Twin Cities, a comparable plan would cost as little as $268.

"I don't know anyone that can pay more than one of their paychecks to be able to afford health care insurance," said Toogood, an archivist at the History Center of Olmsted County. She currently pays $350 per month for insurance for herself and 18-year-old daughter.

Mayo's position as the Rochester area's top health care provider makes it an expensive market for any insurer to enter, said Jean Abraham, a health policy expert at the University of Minnesota.

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She added that it's also a problem in other parts of the country where there's a single, dominant provider.

The Mayo Clinic's costs are higher because it treats patients with very complex illnesses, said Kathleen Harrington, Mayo's government relations chair. Mayo also supports the cost of research and education, which not all hospitals do, she said.

"We're not a community-based hospital. This is an academic medical center that does research, education and top-of-the-pyramid care for the sickest of the sick," Harrington said. "The cost is naturally higher."

Officials with Medica, another major Minnesota provider, said they're working with regulators to offer individual and small group plans in Rochester on the exchange as early as next year. The company currently offers plans in the rest of Olmsted County, but not in the two Rochester ZIP codes.

"Right now we are expecting that all of the products that we offer throughout southeastern Minnesota will also be available in Rochester," Medica vice president Dannette Coleman said. "It's just not quite final yet."

State Commerce Department officials say they're aware choices and costs may be a problem for some in Rochester and hope to change that.